Prevalence and factors associated with acute malnutrition among children with epilepsy at the national referral hospital in Uganda, a cross sectional study.

Background Sub-Saharan Africa carries a significant burden of epilepsy and malnutrition. Although both epilepsy and malnutrition are widespread in low and middle income countries, the burden of acute malnutrition among children living with epilepsy is still unknown. This study aimed to determine the prevalence and factors associated with acute malnutrition among children with epilepsy. Methods This cross-sectional study enrolled children with epilepsy aged 6 months to 12 years attending the paediatric neurology outpatient clinic at Mulago National Referral Hospital, Uganda. Enrolled children underwent clinical exam and clinical history was collected. We used World Health Organization (WHO) growth reference z-scores to categorize children and defined acute malnutrition as children with weight for height z-scores or BMI for age Z score of < -2 Standard deviation. To determine the associated factors, multivariable logistic regression analysis was done and adjusted odd ratios(aOR) as well as 95% confidence interval (CI) was used to estimate the strength of the association. A p-value of < 0.05 was considered statistically significant. Results We enrolled 280 children with epilepsy. The median age (IQR) was four years (1.9–7.5) and 187 (66.8%) were male. Out of the 280 participants, 44 (15.7%) had acute malnutrition. The factors associated with increased odds of acute malnutrition included gross motor impairment (aOR 8.33, 95% CI: 2.27–34.50, p = 0.002), ongoing seizures in the last 6 months (aOR 5.65, 95% CI: 1.34–33.90 p = 0.03) and feeding difficulties (aOR 3.19, 95% CI: 1.23–8.54, p = 0.018). On the other hand, school attendance (aOR 0.12, 95% CI: 0.03–0.41, p = 0.001), rural residence (aOR 0.5 95% CI: 0.22–0.99, p = 0.048) and caregiver with primary or no education (aOR 0.4, 95% CI: 0.19–0.88, p = 0.018), were associated with reduced odds of acute malnutrition. Conclusion The prevalence of acute malnutrition was high among this vulnerable population of children. There is a need to routinely carry out nutritional assessment for children with epilepsy especially those with on-going seizures, motor disabilities and feeding disabilities.